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General NPI Number Information
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NPI Number | 1548330319
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Entity Type | Individual
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Provider Name | JOHN F SIDOLI LPC
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 VANCE DRIVE
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City | MIDDLETOWN
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State | CT
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Zip | 06457
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Country | US
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Telephone | 860-344-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 148 CANAL ST
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City | WESTERLY
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State | RI
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Zip | 02891-1553
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Country | US
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Telephone | 401-348-0135
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000384
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License Number State | CT
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